Tumors and tumorous conditions of the hand
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Transcript of Tumors and tumorous conditions of the hand
TUMOURS AND TUMOROUS CONDITIONS OF THE HAND
Prepared by:Dr.mohamed Abd alhussein LaftahBAGHDAD UNIVERSITYALKINDY COLLEGE OF MEDICINEAlwasity teaching hospital
Hand tumors arise from any tissue—skin, subcutaneous tissue,tendons, nerve, blood vessels, and bone.
Hand tumour can be classified in many different ways which may cause confusion between types and their management plan.
This lecture mainly concerned about how to classify them in simple and accurate way.
Benign tumors account for 95% of hand masses if skin cancers are excluded.
Ganglions represent 60 to 70% of hand tumors, followed in frequency by inclusion cysts, warts, (verruca vulgaris),giant cell tumors of tendon sheaths, foreign body granulomas,lipomas and hemangiomas.
Hand tumour can be classified into major 3 type:
1. Benign tumors.2. Malignant tumors .3. Tumorous conditions .
Each of benign and malignant type can further be classified according to tissue of origin into:
1. Bone tumour.2. Soft tissue tumour.3. Skin tumour.
Benign tumours1. Bone tumours:Enchondromas OsteochondromasOsteoid oseoma.Benign osteoblastoma Aneurysmal bone cyst Giant cell tumors of bone Synovial chondromatosis .OsteophyteChondromixoidfibroma
Enchondromthe most common primary hand bone tumor,occurs chiefly in the 3rd and 4th decades It occurs most commonly in the phalanges, usually in the proximal phalanx
Osteochondroma
consists of a bony prominence at the level of the metaphysis covered by a cartilaginous cap.
Osteoid osteoma is an unusual hand tumor occur in phalanges, metacarpals,and carpal bones, and presents in the 2nd and 3rd decades of life with aching pain that is greatest at night. classically relieved by aspirin
Giant cell tumors of bone
Aneurysmal bone cyst
Synovial chondromatosis .
Osteophyte
Chondromixoid fibroma
2.Soft tissue tumours: Muscl : leiomyoma. Tendon: fibroma of tendon sheath.Giant cell tumor of tendon sheath
(xanthoma of the tendon Sheath).Xanthoma Tuberosum
leiomyoma
fibroma of tendon sheath
Giant cell tumor of tendon sheath
Xanthoma Tuberosum
Fibrous tumour:FibromaDermato fibroma (fibrous
histiocytoma)Nodular fasciaitis.Firomatosis. Juvenile Aponeurotic Fibroma Infantile digital fibroma.
Juvenile Aponeurotic Fibroma
Fibroma
Dermato fibroma
Nodular fasciaitis
Firomatosis.
Infantile digital fibromatosis
Adipose tissue tumour:Lipoma. Infiltrating lipomas. Lipoblastomas. Intraneural lipofibromas.
Lipoma
Tumors of Peripheral Nerves: Neurofibroma. Schwannoma. Granular Cell Tumor. Neurothekeoma (pacinian neurofibroma). INTRANEURAL TUMORS OF NONNEURAL
ORIGINNumerous nonneural tumors have been reported
in peripheral nerves: lipomas, lipofibromatous hamartomas, and hemangiomas.
Neurofibroma
Schwannoma
Granular Cell Tumor
Neurothekeoma median nerve
Vascular Tumors:Hemangioma . Vascular malformation .Lymphangioma .Post traumatic vascular lesion:Traumatic fistulasAtherosclerotic aneurysms.Pyogenic granuloma.Glomus Tumor
Hemangioma
Vascular malformation
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Lymphangioma
Pyogenic granuloma
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Glomus Tumor
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Skin
Benign tumour of skin can be classified according to structure of origin in the skin:
epidermal layer:verruca vulgaris(wart).Keratosis:seborrheac,actinic,solar,irra
diation.ProkeratosisCutaneous HornsKeratoacanthoma
verruca vulgaris(wart).
Keratosis:
Cutaneous Horns
Keratoacanthoma
Tumors of epidermal appendages Pilomatricoma(calcifying epithelioma
of Malherbe) Eccrine poroma . Eccrine Spiradenoma.
Eccrine poroma
Eccrine Spiradenoma
Pilomatricoma
fibrous dermis:Pigmented NeviBlue NeviDermatofibroma
Pigmented Nevi
Blue Nevi
Malignant hand tumours
Bone :Osteogenic Sarcoma.Chondrosarcoma.Ewing Sarcoma.Bone Tumors of the Hemopoietic
System e.g. Malignant lymphomasMetastatic lesion
Osteogenic Sarcoma
Chondrosarcoma.
Ewing Sarcoma
Metastatic lesion
Hand Soft tissue malignancy Its mainly sarcoma: Clear cell sarcoma Dermatofibrosarcoma protuberance. Extra abdominal desmoid. Epithelioid sarcoma. Fibrosarcoma. Kaposi sarcoma. Malignant fibrous histiocytoma. Rhabdomyosarcoma. Synovial sarcoma. Acralmyxoinflammatory sarcoma. Fibroblastic sarcoma. Myofibrosarcoma.Mlignant neural tissue: Neurosarcoma Malignant schwannoma.
Dermatofibrosarcoma protuberance.
Epithelioid sarcoma
Fibrosarcoma.
Skin malignancy
Basal cell carcinomaSquamous cell carcinoma.Malignant melanoma.Sweat gland carcinoma.
Sweat gland carcinoma
Tumorous conditions
Its usually not true tumour we can subdivide them to :
1. Cystic leision: Ganglion cyst. Epidermoid cyst (inclusion cyst) . Sebaceous cyst
Ganglion cyst
DIP Ganglions
Epidermoid cyst (inclusion cyst)
Sebaceous cyst
2.Non cystic leision:Foreign body reaction.Gouty leisionCutaneous Horns Infection: Viral: e.g. wart Bacterial. Fungal.
Foreign body reaction.
The biggest hand in the world
Thank you